Current status of medical expulsion therapy for urinary calculi

Abstract

The current, predominant therapies to remove urinary calculi include the minimally invasive treatments of extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureteroscopy (URS), and laparoscopy. Conservative medical expulsion therapy is certainly a desirable option for urinary stone removal. This chapter summarizes the application of noninvasive medical expulsion therapy utilized in previous clinical experiments. Related drugs include α1-receptor blockers, calcium channel antagonists, nonsteroidal anti-inflammation drugs and prostaglandin synthesis inhibitors, gonadal hormones, glucocorticoids, potassium sodium hydrogen citrate, and even some traditional Chinese medicines. Although medical expulsion therapy of urinary calculi has yielded encouraging results, further double-blind, placebo-controlled studies ought to be performed to better evaluate the current medicines and to develop other treatments.